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The Spectrum of Duodenal Histologic Findings in Patients With Trisomy 21: A Multicenter Study.

Authors :
Alexander E
Stahl M
Weaver A
Devara J
Fahey LM
Singh A
Leonard MM
Weisbrod V
Shull M
Silvester J
Kramer Z
Kerzner B
Liu E
Absah I
Source :
Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2023 Aug 01; Vol. 77 (2), pp. 184-190. Date of Electronic Publication: 2023 May 12.
Publication Year :
2023

Abstract

Objectives: Patients with Trisomy 21 (T21) commonly have gastrointestinal symptoms and diseases that prompt evaluation with esophagogastroduodenoscopy (EGD). Our objective is to characterize duodenal histological abnormalities in these patients when undergoing EGD. A secondary aim is to explore associations of histologic findings with different therapies.<br />Methods: Patients 30 years old or younger with T21 who underwent EGD from 2000 to 2020 at 6 hospitals were included in this retrospective cohort study. Duodenal biopsies were categorized based on reported histopathology findings as normal or abnormal. Abnormal pathology reports were reviewed and categorized into villous atrophy (VA) and duodenitis without VA. The VA group was further categorized based on the presence or absence of celiac disease (CD).<br />Results: We identified 836 patients with T21 who underwent EGD, 419 (50.1%) of whom had duodenal histologic abnormalities. At the time of the first (index) abnormal duodenal biopsy, 290 of 419 had VA and of those, 172 of 290 met CD diagnostic criteria, while 118 of 290 did not meet CD criteria (nonspecific VA). Among the patients with an abnormal biopsy, acid suppression at the time of the index biopsy was less common in patients with VA-CD compared to patients without VA or patients with nonspecific VA (12.2% vs 45.7% vs 44.9%).<br />Conclusions: Half of the T21 patients in this cohort had abnormal duodenal biopsies including a subgroup with nonspecific VA. In this cohort, acid suppression use was more prevalent in patients with abnormalities other than CD.<br /> (Copyright © 2023 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Details

Language :
English
ISSN :
1536-4801
Volume :
77
Issue :
2
Database :
MEDLINE
Journal :
Journal of pediatric gastroenterology and nutrition
Publication Type :
Academic Journal
Accession number :
37184455
Full Text :
https://doi.org/10.1097/MPG.0000000000003825